Smartphone apps are increasing in popularity and are being widely used in healthcare as health apps, but more research needs to be conducted on their efficacy as patient adherence tools, according to a survey by Consumer Health Information Corporation (CHIC).

The survey was distributed to smartphone consumers at affiliated universities, businesses and posted on Facebook in April 2011.  Survey results were collected from 395 respondents.  

The CHIC survey stems from a March 2011 consumer survey showing that 26 percent of apps are downloaded and used only once.  Of the people who confirm using their apps, 74 percent drop out by the 10th use.  The same survey, however, also shows that 26 percent of smartphone applications retain consumer loyalty and are used repeatedly. 

The CHIC survey shows that the availability of a better app (34.4 percent) and lack of user friendliness (32.6 percent) are the top reasons for discontinuation of smartphone apps.

In general, ease of navigation (90.9 percent) was the top feature that made apps favorable.  In terms of interest in health apps, the majority of surveyed consumers stated that they would be most interested in using a health app to gain information (91.1 percent).

Behavioral scientists hypothesize that in order for health apps to be successful and change patient behavior, they should target motivational needs to promote behavioral change.  The majority of surveyed consumers agreed with this and stated that they would be more likely to use an interactive app that can analyze logged information and provide feedback (79.9 percent).  Based on this response, personal feedback is key because it will provide the motivation for behavioral change.

Health apps should also comply with proven public health guidelines.  A study that looked at smoking cessation apps found that the majority were not evidence-based nor rooted in proven methods of usefulness for smokers.  Of the 47 smoking apps identified and analyzed in the study, none met the guideline recommendations.  For health apps to be successful patient adherence tools, they should follow established evidence-based guidelines.

The CHIC survey also found that:

• Consumers were most likely to use a health app to find information about drugs (42.2 percent) or disease states (26.5 percent).
• 39.8 percent were willing to use such a health app several times a day.
• National health organizations were the most trusted source of health information (51.8 percent).
• The majority of consumers were either somewhat influenced by (55.8 percent) or very much influenced (32.2 percent) by consumer ratings of apps.
• 33.4 percent of consumers preferred health apps to be free but the majority were willing to pay, with 30.9 percent willing to pay $1.00-$5.99.
• In terms of preference for health-related task reminders, consumers did not want phone calls, drug vials, or email reminders.  The majority of consumers preferred reminders through their mobile phones such as text messages (41.1 percent), smartphone apps (20.3 percent), or phone alarm (19.5 percent).

Ultimately, it is the patient who decides whether or not they will continue to use an app or take a drug.  Patients will not use a smartphone app simply because it is innovative or handy.  Instead, they want something that is convenient and will help them simplify their health-related tasks.  Furthermore, it is not enough to have a health app that merely helps to manage or keep track of one's health, patients also desire feedback.  Such an app should also be accurate and follow clinical and behavior modification guidelines.

The high dropout rate with smartphone apps is concerning to the healthcare industry because smartphone apps are beginning to play an important role in healthcare.  The most recent pharmaceutical industry report by Ernst & Young from February 2011 reveals that in 2010 new initiatives in health technology by pharmaceutical companies increased by 78 percent.  A staggering 41 percent of those new initiatives were smartphone apps.  For the time and resources invested, pharma companies need to ensure that their investments in smartphone apps do not fall into the 26 percent that are used only once but rather into the 26 percemt that are used repeatedly.

Smartphone health apps will be effective as patient adherence tools only if they are able to retain consumer loyalty.  Based on the results of this survey, our company concludes that while smartphone apps represent an innovative method of patient outreach and education, more research needs to be conducted on their efficacy as patient adherence tools.